Positioning Alert

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To Dr. _____________________ and the surgical team,

I have Hereditary Neuropathy with liability to Pressure Palsies (HNPP). HNPP makes my nerves unusually susceptible to injury from: pressure (internal or external), stretch, or repetitive use. Injury from any of the above may result in partial and/or complete numbness and/or weakness (pressure palsies) which may last for several hours to several months and may sometimes be permanent. Injury can occur in a matter of minutes. Arms and legs are most prone to injury, especially at the common entrapment sites, but this may also affect the face, scalp and trunk.

To date, no studies have been done on the effects of positioning during surgery in patients who have HNPP. There have been anecdotal reports of pressure palsies lasting 2 - 6 weeks from tucking arms against the side, leaning against the patient during surgery and from ET (breathing) tubes taped off to the side and supported by the mouth. There have also been anecdotal reports of no pressure palsies when preventative measures have been taken.


As appropriate to the kind of surgery I am having, the following steps may help to reduce my chances of pressure palsies during surgery:

Thank you,



If you have any questions, please call my neurologist, Dr. ____________________ at______________________

Last updated: 5/04, last reviewed 5/04